0001144204-18-020661.txt : 20180416 0001144204-18-020661.hdr.sgml : 20180416 20180416142528 ACCESSION NUMBER: 0001144204-18-020661 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161221 FILED AS OF DATE: 20180416 DATE AS OF CHANGE: 20180416 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHEFTS MARK CENTRAL INDEX KEY: 0001270809 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37899 FILM NUMBER: 18756321 MAIL ADDRESS: STREET 1: 160 SUMMIT AVE CITY: MONTVALE STATE: NJ ZIP: 07645 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Alliance MMA, Inc. CENTRAL INDEX KEY: 0001674227 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS AMUSEMENT & RECREATION [7990] IRS NUMBER: 475412331 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 590 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 2127397825 MAIL ADDRESS: STREET 1: 590 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10022 4/A 1 tv491139_form4a.xml OWNERSHIP DOCUMENT X0306 4/A 2016-12-21 2018-01-26 0 0001674227 Alliance MMA, Inc. AMMA 0001270809 SHEFTS MARK C/O ALLIANCE MMA, INC. 590 MADISON AVENUE, 21ST FLOOR NEW YORK NY 10022 1 0 0 0 Common Stock par value $0.001 2017-08-29 4 P 0 183486 200000 A 222374 D Common Stock par value $0.001 151389 I See Footnote Warrant to Purchase Common Stock 7.43 2016-12-21 4 J 0 44446 A 2017-03-02 2021-09-02 Common Stock, par value $0.001 44446 44446 D Warrant to Purchase Common Stock 1.50 2017-08-29 4 P 0 183486 A 2018-03-01 2020-08-28 Common Stock, par value $0.001 183486 227932 D In addition to the 222,374 shares of common stock held directly, this also includes 151,389 shares held by the Rushcap Group, Inc., of which Mr. Shefts and his spouse, Wanda Shefts, are the sole stockholders. Mr. Shefts has voting and dispositive power over the shares held by the Rushcap Group, Inc. Warrants allocated to Network 1 Financial Securities, Inc., during the initial public offering that were allocated to Mr. Shefts in conjucntion with initial public offering, prior to Mr. Shefts becoming areporting person. Fully vested warrants were issued in a prior reported purchase on the Form 4 filed on January 26, 2018. The warrants were issued at a rate of one warrant per one share of common stock at a unit price of $1.09 per unit. The original Form 4, filed on January 26, 2018, is being amended by this Form 4 amendment to correct an administrative error, which misreported a purchase that occured on October 20, 2017 as a total of 183,486 shares of common stock, when in fact an equal number of warrants to purchase common stock were also included in that purchase and the correct purchase date was August 29, 2017. As a result of this administrative error, the number of derivative securites beneficially owned by the reporting person is updated in Table II. /s/ Mark Shefts 2018-04-11